Recently, a friend of mine wrote a cheque for Rs 14,45,000, the sum total of the hospital and care bill for his father. And this amount was spent in less than six months. At least, this friend works in a great company has a great salary, and a very, very high savings (and investment) rate. He knew exactly where this money would come from, which was from his bulging equity mutual fund portfolio.

If this were to happen to somebody dependant on you, who will pay the bill?

You?

Your employer?

Your children?

Your children’s inheritance?

Your spouse? In case you do not know ‘Who’ is going to pay such a bill if you are the earning member, look at ‘medical insurance’. When we think of insurance, we think of tax breaks. Or a favor to some relative who is not so well off or a colleague’s wife who is pushing you to do her a ‘favor’ to cover the minimum number of lives. If you are in that category, wake up.

You need ‘medical insurance’ today. Considering the increasing costs of medical care in India, it is becoming necessary to have a safety net, for individuals to fall back on, in case they face an event of hospitalization following a medical emergency.

In case, you are wondering how this bill went as high as Rs 14 lakh, join me. I also wondered, then had a peek at the bill – hospital bed charges, nursing, nursing at home, medicines, assisted living, the works. Lack of good quality financial data, collection and analysis is not available in Indian conditions. Take a look at the statistics in the US and you will be scared.

More than 40% of the people who needed assisted living were working people.

Long-term care insurers have so far paid USD 6 billion in claims. The cost of medical treatment is a definite burden on the resources of an individual, whether salaried or self-employed. They may deplete or in major cases, wipe out the entire savings of a household. In India, the insurance industry as well as the medical fraternity would love to have details on the average age of the cardiac patients, the average age at which cholesterol becomes a cause for worry etc. However, we have no reliable statistics.

As a wealth consultant, I do come across many persons under 40 who have diabetes, cholesterol, stress, but still live in denial when it comes to having general insurance on their own.The average costs for cardiac ailments/ procedures are in the range of Rs. 15,000-20,000 for angiography and upward of Rs 2,00,000 for angioplasty, with CABG (coronary angio bypass graft) costing upward of Rs 3,50,000. For major orthopaedic procedures like replacement of joints cost upward of Rs 1,50,000 and even routine procedures like fistula, hernia do cost in the region of Rs 75,000. These costs are quantifiable, and transferable at a premium, why not avail it when you can? In case, you are already afflicted by some disease, the medical insurance will no longer be available. At that stage all you can do is repent.

If you are young, this is the time to take insurance. In case, you are supporting (or likely to support) some elder relative, it makes sense to take medical insurance now. Do not wait for the disease to strike.

Apart from these ‘insurable’ costs there could be other costs for which you need to create your own kitty – nursing, adult diapers, special equipment, assisted living etc. In India we still do not have ‘long-term care insurance’ and this means you have to find your own solutions to such problems.
The medical insurance market offers many of the shelf products to most people – and the premium is likely to go up in the near future. Once there is detariffing of the premium, you will see many innovative products, but nothing is likely to be cheap. However, when you think you might end up staring at a bill of Rs. 20 lakh, start early.

What triggered me to put this article? well, this email did it:
“I have got Reliance ADAG Heathwise Gold Policy for Family since last 3 years. The last premium I paid in March 2010 was around 5k Rs.

Recently I have received a communication from them, notifying me that the premium for me in the coming year would be 4 times more than what I paid last year.

This is when I have a history of absolutely no claims.

Do you know of any such arbitrary premium increases. I would be
obliged if you can advise about the mediums what can be used to fight
out such out of the ordinary premium increases.”

email from Mr. SK – not naming him..serves no purpose, does it?

Related Articles:

Post Footer automatically generated by Add Post Footer Plugin for wordpress.

  1. I think you should take a mediclaim policy from a govt. backed entity.
    They may be a bit expensive or a bit non-innovative product. They are not concerned about the profits to the shareholders. The people who pass/reject the claims may not get additional incentives for rejecting the claims. Whereas there may be a culture in other organizations where a employees growth and incentives will be linked to how much claims they reject.

    Though I don’t have any hard facts on the above, but I do believe the same is very true. Your opinion please.

  2. Reply to Mr. SK:

    Nothing can be done..walk over to New India – or any one of the government companies. Fill the form honestly, make only honest claims…and you will be happy.

  3. Sir,

    What do you suggest for people who are working and have medical insurance, Certainly we wont be requiring insurance for some time (till we are working ) as we are covered in group policy in our work place, however i do think that when we quit or old, we would require it and it would be quite expensive, so what can be done so that we can save for old age (medical).

  4. I have been with National Insurance for the last 3 years and am satisfied with their services. The also settled my claim promptly.

    Rakesh

  5. Subra,

    What do u think products bundled with Bank A/C (holder) by nationalized general insurance company . ( ie national insurance has mediclaim policy for baroda/uco bank). Premium on these product is relatively ~40% less. Not sure if insured person experience is same as “individual/family” policy.
    Any light on it?

  6. Regarding the 14 lakh rupees that your friend paid, I must say that medical insurance would not have helped him much either !! Yes, almost all medical insurance policies have a limit of Rs 2 lakh only (4 lakh if two people are grouped together). So he would have ended up paying 12 lakh anyway. Not to mention the “clever reasons” that insurance compnies cook up later to NOT give the 2 lakh also !!

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes:

<a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>